摘要:

Prolonged fasting (NPO) and total parenteral nutrition (TPN) have been reported to result in an unacceptable number of false-positive hepatobiliary scintigrams for acute cholecystitis. Based on these reports, the clinical usefulness of the hepatobiliary scan in diagnosing acute cholecystitis in the critically ill postoperative patient who has been NPO or on TPN has been questioned. Patients who were either on prolonged fasting or total parenteral nutrition and who had no history of hepatobiliary disease were prospectively studied to assess the value of the Tc-99m diisopropyl-iminodiacetic acid (DISIDA) scan without pretreatment with cholecystokinin (CCK) in such a setting. Of the 17 persons studied, nine had been on total parenteral nutrition for at least five days and eight had been fasting for at least five days prior to imaging. Seven of the nine individuals on TPN (78%) and six of the eight individuals who were NPO (75%) had normal hepatobiliary scintigraphy. The results suggest that hepatobiliary imaging with Tc-99m DISIDA has a lower false-positive rate in individuals on TPN or NPO than previously has been reported and that it has clinical efficacy in ruling out the diagnosis of acute cholecystitis in these individuals.

ISSN:0363-9762    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Three clinically unsuspected malignant pericardial effusions were discovered during routine dynamic hepatic scintigraphy. The only common clinical feature shared by the patients was dyspnea. Static scintigrams alone would not have detected these effusions, which points out again the importance of including dynamic scintigraphy in routine radionuclide evaluations of the liver.

ISSN:0363-9762    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Colonic varices is a rare condition, generally associated with portal hypertension, which normally presents as acute, severe, gastrointestinal blood loss. A case is presented in which the varicosities were observed serendipitously in a patient with a pancreatic tumor, in whom the bleeding was not variceal but due to two small unrelated gastric hemangiomas. The literature is reviewed and scintigraphic features described.

ISSN:0363-9762    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

There have been reports (1,2) regarding the efficacy of Tc-99m labeled RBC venograms. The authors have found that potentially dangerous iliac vein occlusions can be missed unless especially careful attention is paid in looking for (a) any asymmetry of the iliac vessels with respect to intensity, thickness, and/or definition, along the whole or at least 50% of one of the vessel's length, and (b) the presence or absence of blood pool activity in the most proximal portion of the left common iliac vein, i.e., whether the activity arises from the IVC or the aorta. Eight (21%) of 38 consecutive labeled RBC venograms performed at this institution over six months produced findings that met criteria (a) and/or (b). Iliofemoral vein occlusion was confirmed in six of the eight patients (16% of all patients). Thus, while the above criteria are not pathognomonic for iliofemoral vein occlusion, their rigid application has enabled the authors to detect a significant proportion of patients with iliofemoral occlusions which would otherwise have gone undetected. All eight cases were confirmed by further workup with direct injection radionuclide venography or contrast venography.

ISSN:0363-9762    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Phase imaging abnormalities of the right side of the heart detected on multiple gated blood pool angiography (MUGA) have received less attention than similar abnormalities of the left ventricle. It has been found that certain different patterns of phase abnormalities of both right ventricle and right atrium are useful in the detection of six pathological conditions: right bundle branch block, ischemic right coronary artery disease, pericardial effusion, tricuspid regurgitation, pulmonary hypertension, and atrial septal defect. The authors emphasize the importance of these abnormal phase patterns during interpretation of gated cardiac studies, as they are helpful in directing the physicians attention towards the proper diagnosis.

ISSN:0363-9762    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Radioisotopic angiography of the splenic vein was performed in six patients following a distal splenorenal shunt (Warren procedure). Under echographic guidance, the spleen was punctured with a 22-gauge needle, and Tc-99m pertechnetate was injected into the splenic pulp. In five patients whose esophageal varices had remained atrophic, the splenic vein, the left renal vein, the inferior vena cava, and the heart were clearly visualized within 8 seconds. In one patient, in whom recurrence of esophageal varices had been recognized, the splenic vein was not imaged. The injected material coursed mainly upwards through collaterals.

ISSN:0363-9762    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Whole bone activity on skeletal scintigraphy in children, although nonspecific, is uncommon arid was caused by unusual presentations of osteomyelitis in two of eight patients. Soft tissue pathology, including cellulitis and vascular obstruction, was causative in four of eight cases. Whole bone activity was seen in two children with trauma due presumably, to subperiosteal hematoma formation and strongly supported the diagnosis of child abuse.

ISSN:0363-9762    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Plummer's disease presents a spectrum of forms and its evolution is often slow. Longitudinal studies have been limited both in number of patients and duration of follow-up. In order to answer the question of whether euthyroid patients with no local symptoms should be treated prophylactically, 70 patients were reexamined 5.2-21.8 years (average, 8.9) after Plummer's disease had been diagnosed. Data are included on four others who developed symptoms that indicated treatment within five years. Gross (clinically relevant) changes were seen in 24 cases. Of these, 16 were progressive, including 12 where hyperthyroidism developed. Gross regressive changes included two cases with complete remission. Minor changes (28 cases) were about as often regressive as progressive. Most patients with a solitary autonomous nodule showed either gross changes or no change, whereas minor changes prevailed in multifocal autonomy. All eight male patients had a solitary nodule, 28 of 66 females had multifocal autonomy. Gross changes were seen in nine of 12 patients under 40 years at presentation, more often than in those over 49 years; seven of these changes were progressive. Six short case reports illustrate the great diversity in evolution. It is concluded that treatment seems wise in teenagers and in elderly patients with borderline (biochemical) hyperthyroidism but others generally may be left untreated, as long as they have few or no complaints.

ISSN:0363-9762    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Three children are reported with vesical filling defects on scintigraphy secondary to extrinsic causes. In two chronically constipated individuals undergoing bone scintigraphy, the extrinsic pressure on the bladder by rectosigmoid feces resulted in simulation of intrinsic space-occupying lesions. Focal attenuation of bladder activity on nuclear cystography by the metal distal hook of a Harrington rod also produced the pseudo-appearance of a vesical filling defect in a third patient.

ISSN:0363-9762    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Twenty patients with ununited fractures and a suspicion of infection had ln-111 chloride imaging. Surgically obtained cultures were positive for infection in 12 and negative in eight patients, ln-111 chloride images were positive in all 12 patients with infection but also were positive in six of the patients with negative cultures. It is not possible to differentiate infected from noninfected ununited fractures by ln-111 chloride imaging.

ISSN:0363-9762    

出版商:OVID    

年代:1987

数据来源: OVID